Mammograms and risk

In a society dominated by high-tech medicine, it’s big news when computer power fails to make much of a difference. That’s the surprising result of the first comprehensive study of a popular technique used in mammograms. It’s called computer-aided detection, and it is supposed to improve the interpretation of mammograms by flagging suspicious areas on the breast X-ray for the radiologist to review. But it turns out that it’s less accurate than mammograms read the traditional way, by humans.

The researchers who reported the results in Thursday’s New England Journal of Medicine say that the new technology is harmful because it finds more suspicious lumps and leads to more biopsies without significantly improving the breast cancer detection rate. But other doctors are less negative, saying the best way to summarize the finding is: The computers aren’t helping.

So what does this mean to most women, who probably don’t know whether a computer is assisting their doctor in reading their mammogram?

On the same day as the study was released, Elizabeth Edwards, wife of Democratic presidential candidate John Edwards, fielded a question about mammography and revealed that she had neglected to get a regular mammogram. By the time she felt a lump in her breast in 2004 and had it removed, the cancer had spread. Two weeks ago, Edwards revealed that the cancer had returned in an incurable form.

“I do not have to be in this situation,” Mrs. Edwards told the audience. The cancer “had the chance to migrate because I sat at home doing whatever I thought was important and didn’t get mammograms. It wasn’t that I didn’t know.”

Yes, some of these studies can give mixed messages. But the overarching message is simple: Talk to your doctor about when you should start getting regular mammograms. Then do it.